Cost Proposal Worksheet v2

120 KB Posted

Attached to
Serological Immunoassay Lease and Services
Solicitation number
40500-DPH0000066
Issued by
Georgia

About this file

This is a Cost Proposal Worksheet related to a Request for Quotes (eRFQ) issued by the Georgia Department of Public Health for Serological Immunoassay instrumentation lease and related services. The eRFQ was issued pursuant to the State Purchasing Act (Official Code of Georgia Annotated 50-5-50 et seq.) to establish a contract with a qualified supplier to provide a comprehensive range of services related to serological immunoassay instrumentation. The original eRFQ was canceled without award on February 24, 2014, at the Department's discretion, with the Department reserving the right to reissue a replacement bid event. The solicitation document provided is a cost proposal worksheet template intended for vendors to submit pricing information for the lease and services related to the instrumentation and associated support.

The cost proposal worksheet serves as the standardized format for respondents to provide their pricing terms and cost structure for the serological immunoassay lease and services contract. While specific pricing details, renewal options, contract term length, and other financial requirements are not detailed in the file summary provided, the worksheet would have required vendors to itemize costs associated with equipment lease, maintenance, support services, and any other related expenses. The cancellation and planned reissuance of the eRFQ suggests the Department was seeking to modify requirements or improve the procurement process prior to moving forward with vendor selection.

Text of this file

Instructions

General
General Information: As this program is funded entirely with federal dollars, strict rules exist regarding allowable and unallowable expenses. These rules are specified in Office of Management Budget (OMB) Circular A-133: Cost Principles for Non-Profit Organizations at http://www.whitehouse.gov/omb and http://www.whitehouse.gov/sites/default/files/omb/assets/a133/a133_revised_2007.pdf (HTML web link below). The DPH will review each offeror's proposed budget and work with success offerors to ensure all budgeted costs are allowable under OMB Circular A-133.

Offerors must complete the budget details and justification in its entirety, no exceptions. Missing, incomplete, or inconsistent information can result in delays, disallowance of certain expenditure(s), in part or whole, and/or proposal disqualification.

The following detailed/line by line instructions for the Cost Proposal and Budget Details Justification Worksheet(s) are designed to facilitate ease of use in submitting pricing proposal. Please read the instructions entirely.

#Column/FieldHeader / FunctionInstruction Details
Tab 11AllInstructionsContain detail instructions for completing the Cost Proposal (Tab 2) and Budget Details and Justification (Tab 3) worksheets.
Tab 22G2Cost Proposal WorksheetGeneral Information

Except for the date and company information fields, the Cost Proposal Worksheet (Tab2) is password protected. This worksheet contains the proposed budged summary and is automatically populated by data entered into corresponding fields on the Budged Details and Justification worksheet (Tab3)

The Cost Proposal Worksheet has limited access and cannot be manually changed. To reconcile data populated to Tab 2, double check figures entered on Tab 3 to ensure data accuracy.

Offeror MUST complete all yellow highlighted fields on Tab 2 Cost Proposal Worksheet

3G2Enter date of completion (this entry automatically populates the corresponding cell (H3) on Tab 3)
4D9Enter Company's name (this entry automatically populates the corresponding cell (D3) on Tab 3)
5D10Enter the company's business/physical address
6D11Enter the company's business/physical city, state and zip code
7F9Enter the contact person's name and title
8F10Enter the contact person's phone number
9F11Enter the contact person's business email address
Tab 310D-H,JBudget Details Justification WorksheetBudget Details and Justification Worksheet contain the budget line details and justification. This worksheet is interactive, except for cost totals at the end of each section. The cost total cells are set to automatically calculate each category and populate the corresponding cell(s) on Tab 2.

Offeror is required to list all line items and provide justification, per the instructions, for each expenditure. Failure to provide justification may result in disqualification of the line item, expense, and/or proposal.

Please follow the line-by-line instructions below for completing this worksheet.

11 D Personnel Position Type/Title Enter the description or title of each position that will be assigned to work on the corresponding program. Also indicate if the position is full-time (FT) or part-time (PT). Do not list non-paid or volunteer positions in this section.

12 E Employee Name Enter the employee's first initial/last name (if available). Entries here must be supported by resumes' and job descriptions provided in response to the corresponding eRFx/contract agreement (where applicable).

13 F Annual Salary:

Enter 100% of the annual salary for this position/employee; even if the position/employee is assigned to work on multiple programs for this project. The annual salary relative to the individual program is automatically calculated in in the annual cost(s) field (Column I), which is predicated on the percent of program effort (Column H).

14 G Project (% of effort spent on the entire project):

Enter the percent of time the position/employee is expected to be allocated to this contract as a whole, during the term of this agreement. The employee's time allocation includes the sum total of time spent working on all activities/seminars outlined in the agreement.

15 H Program: % of effort spent per this specified activity only Enter the percent of time the position/employee will be assigned to work on this specific activity during the contract period. The sum total of the position's/employee's annual salary for all assigned activities shall not exceed 100% of the time allocated for the entire project.

16 I Annual Cost(s):

The field requires no manual entry. The annual personnel costs for this position/employee is set to automatically calculate by dividing the annual salary rate (Column E) by the program % of effort (column G).

17 J Justification:

Enter a description of the specific program's need(s), to include an explanation of how costs were estimated. Describe the job's function and/or how supplies/equipment will be utilized.

1. Offerors are required to provide a line item budget and narrative justification for all requested costs using the Budget Detail and Justification Worksheet provided (Tab 3).

2. A narrative budget justification (column J) is required for all budget line item details. The budget narrative must describe in sufficient detail exactly how the offeror calculated each of its budget line items and category totals. If additional space is needed, please cross reference each budget narrative with the corresponding budget line item and category/section.

3. Line items without valid justification can result in proposal disqualification either in part or whole.

18 D Supplies Item Description:

Enter on separate lines, supplies and materials expected for one-time usage. List program specific supplies under the related program(s) in the space provided. Supplies and materials may include but may not be limited to, pamphlets, brochures, etc. For specific rules related to covered supplies and materials, refer to the OMB Circular A-133: Cost Principles for Non-Profit Organizations.

19 E Rate/Cost:

Enter the rate/cost per each unit of measure 20 F Unit of Measure:

Enter the specified unit of measure (UOM), i.e., each, package, lot, daily, monthly, quarterly, annually, etc.

21 G Total # of Units:

Enter the quantity or the total number of units per year 22 I Annual Cost(s):

This field requires no manual entry. The annual cost(s) for "Supplies" is set to automatically calculate by multiplying the rate/cost per unit (Column E) by the total # of units/quantity, (Column G).

23JJustification: Refer to G20 (above)
24D-H,JOtherList other expenses not covered in any of the previous budget categories. Where applicable, other expenses may include but not limited to: costs related to media production, billboards, t-shirts, and other marketing items, staff and volunteer training (Personnel). Expenses listed here must not be included in the "Indirect cost" section.
25DItem Description:

Enter on separate lines supplies and materials expected for one-time usage. List program specific supplies under the related program(s) in the space provided. For specific rules related to covered supplies and materials, refer to the OMB Circular A-133: Cost Principles for Non-Profit Organizations.

26 E Rate/Cost:

Enter the rate/cost per each unit of measure 27 F Unit of Measure:

Enter the specified unit of measure (UOM), i.e., each, package, lot, daily, monthly, quarterly, annually, etc.

28 G Total # of Units:

Enter the quantity or the total number of units per year 29 I Annual Cost(s):

This field requires no manual entry. The annual cost(s) for "Other" is set to automatically calculate by multiplying the rate/cost per unit (Column E) by the total # of units/quantity, (Column G).

30JJustification: Refer to #17, field G20 (above)
31D-H,JTravelTravel costs entered here are related to the individual program. Be sure to explain need for all travel in the justification section. Local travel policies prevail. For specific rules related to covered supplies and materials, refer to the OMB Circular A-133: Cost Principles for Non-Profit Organizations.
32DPurpose of Travel:

Enter the reason(s) for travel. For specific rules related to travel rules, refer to the OMB Circular A-133: Cost Principles for Non-Profit Organizations.

33 E Location:

Enter the starting location or city of origin (from) and the destination city/location (to).

34 F Item/UOM:

Enter the specified item or unit of measure (UOM), i.e., mileage, hotel, per diem, etc. For specific rules related to travel rules, refer to the OMB Circular A-133: Cost Principles for Non-Profit Organizations.

35 G Total # of Units:

Enter the quantity or the total number of units expected per year 36 I Annual Cost(s):

This field requires no manual entry. The annual cost(s) for "Travel" is set to automatically calculate by multiplying the rate/UOM (Column G) by the total # of units/quantity (Column H).

37JJustification: Refer to #17, field G20 (above)
38D-H,JIndirect CostsIndirect Costs:

Must not exceed 10% of total administrative costs Must not include costs already listed or otherwise accounted for in other categories Examples of indirect costs include but is not limited to: ____________________________________

39DCost Per Unit of Meaure (UOM)Activity: Indicate the type of activity you expect to conduct for this project, i.e., seminar, workshop, ad campaign production, etc.
40ETotal # of Units (seminars, activities, etc.): Indicate the total number of activities you expect to conduct for this project during the term of the agreement. The total number of activities must reflect the sum total of the minimum required plus the number of additional activities planned. The default or place holder number shown in the "Total Units/Activities" field represents the minimum number of required activities. Offerors planning to conduct more than the minimum number of activities or conducting community mobilization and/or surveillance, must indicate as such by increasing the default number to include the total number of activities planned in the corresponding cell.
41FCost per Unit (seminar, workshop, activity, etc.) is automatically calculated based on dividing the Total Annual Costs (each section) by the Total # of Activities. Offeror MUST enter the total number of units in the designated field for activities it plans to expedite.

NOTE: The calculated cost per unit (activity, i.e., seminar, workshop, report, etc.) is based on the number of minimum activities required in the eRFx/agreement and is used for monthly reporting and invoicing. The monthly invoicing amount must be adjusted where the Contractor completes greater than the minimum number of required activities.

42JJustification: Refer to #17, field G20 (above)
References
42GENReference LinksOMB Circular A-133
Office of Management Budget (OMB)
Circulars: Budget | The White House

&C&"Arial Narrow,Bold"&12ATTACHMENT G Cost Proposal&"Arial Narrow,Regular"&10 &A &LGeorgia Department of Public Health Sexual Violence Prevention Education II eRFP #40500-DPH0000049&RPage &P of &N Printed on &D OMB Circular A-133 Circulars: Budget | The White House Office of Management Budget (OMB)

Cost Details

Date:
1Offeror Information
Company NameContact Name, Title
AddressPhone Number
City, State ZipEmail address
2Instrument, Supplies and Services
Item DescriptionLease/Rate# Units [Qnty]Unit of Measure (UOM)
[ea., month, etc.]Total # UOM [ea, months, etc.]Annual Costs
Decatur Instrument Lease:<specify name/type here>1Month12$ - 0
Computer(s) Lease1Month12$ - 0
Printers(s) Lease1Month12$ - 0
Ancillary Equipment Lease:<specify instrument name/type here>1Month12$ - 0
Controls, calibrators, reaction modules, etc.1Month12$ - 0
Supplies:<specify/list supplies here>1Month12$ - 0
PM visit(s):<specify instrument name/type here>1Month12$ - 0
Training(s) [user, installation, etc.]1Each1$ - 0
Travel Expenses (estimate)1Each1$ - 0
Uninterrupted Power Source(UPS) Unit(s)1Each1$ - 0
Miscellaneous expenses(estimated) <specify>1Each1$ - 0
Decatur: Estimate Cost Lease/Service$ - 0
Waycross Instrument Lease:<specify name/type here>1Month12$ - 0
Computer(s) Lease1Month12$ - 0
Printers(s) Lease1Month12$ - 0
Ancillary Equipment Lease:<specify instrument name/type here>1Month12$ - 0
Controls, calibrators, reaction modules, etc.1Month12$ - 0
Supplies<specify/list supplies here>1Month12$ - 0
PM visit(s)<specify instrument name/type here>1Each1$ - 0
Training(s) [user, installation, etc.]1Each1$ - 0
Travel Expenses (estimate)1Each1$ - 0
Uninterrupted Power Source(UPS) Unit(s)1Each1$ - 0
Miscellaneous expenses(estimated) <specify>1Each1$ - 0
Waycross: Estimate Cost Lease/Service$ - 0
Total Estimated Cost Lease/Service (Decatur & Waycross)$ - 0
3Reagent/Test Kits & Supplies
The estimated number of units/tests used to calculate the cost per reagent/tests is based on the FY2013 utilization data for the Decatur Central and Waycross locations; and is not intended to guarantee a minimum or maximum order quantity. All relevant figures shown below will automatically populate the corresponding cell(s) of the Cost Proposal Worksheet (Tab 2).
Test/Reagent NameEst # Units/Tests DecaturEstimated Cost/Test DecaturEst # Units/Tests WaycrossEstimated Cost/Test WaycrossComments

Explain cost/pricing variables, i.e., test type, volume, etc.

Cytomegalovirus IgG826$ - 0- 0$ - 0
Cytomegalovirus IgMCytomegalovirus IgM82$ - 0- 0$ - 0
HSV Type Specific 1HSV Type Specific 16,253$ - 0- 0$ - 0
HSV Type Specific 2HSV Type Specific 26,251$ - 0- 0$ - 0
Measles IgGMeasles IgG1,065$ - 0- 0$ - 0
Measles IgMMeasles IgM9$ - 0- 0$ - 0
Mumps IgGMumps IgG1,031$ - 0- 0$ - 0
Rubella IgGRubella IgG2,352$ - 0- 0$ - 0
Rubella IgMRubella IgM10$ - 0- 0$ - 0
Syphilis IgG/IgMSyphilis IgG/IgM4,099$ - 0936$ - 0
Toxoplasma IgGToxoplasma IgG1,333$ - 0- 0$ - 0
Toxoplasma IgMToxoplasma IgM434$ - 0- 0$ - 0
Varicella Zoster lgGVaricella Zoster lgG1,431$ - 0- 0$ - 0
West Nile Virus IgGWest Nile Virus IgG- 0$ - 0- 0$ - 0
Other (GPHL specified)Other (GPHL specified)- 0$ - 0- 0$ - 0
Total Tests/Facility25,176936
Estimated Cost by Facility$ - 0$ - 0
Total Estimasted Annual Cost$ - 0

&C&"Arial Narrow,Bold"&12ATTACHMENT F Cost Proposal&"Arial Narrow,Regular"&10 &A Worksheet &LGeorgia Department of Public Health Serological Immunoassay Lease & Service, eRFQ 40500-DPH0000066&RPage &P of &N Printed on &D

Cost Proposal Worksheet

Event Name:Serological Immunoassay Lease and Services, GPHLDate:12/31/99
Event ID:eRFQ 40500-DPH0000066
Offeror Name
Company Name0Contact Name, Title0
Address0Phone #0
City, State Zip0Email address0
Section 5 “Cost/Pricing”
Unless otherwise specified in the solicitation (eRFx or Sole Source) or contract agreement, all pricing should be inclusive of all costs associated with providing the services outlined in the sourcing document (i.e. shipping, postage, etc.). Supplemental Cost Data is neither required nor desired.
Electronic Funds Transfer?
Remit to
Georgia Department of Public Health
Attention:
2 Peachtree Street, NW |Atlanta, Georgia 30303
COST PROPOSAL AND BUDGET DETAIL SUMMARY
Test/Reagent NameCost/Test DecaturCost/Test WaycrossComments
Cytomegalovirus IgG$ - 0$ - 0
Cytomegalovirus IgM$ - 0$ - 0
HSV Type Specific 1$ - 0$ - 0
HSV Type Specific 2$ - 0$ - 0
Measles IgG$ - 0$ - 0
Measles IgM$ - 0$ - 0
Mumps IgG$ - 0$ - 0
Rubella IgG$ - 0$ - 0
Rubella IgM$ - 0$ - 0
Syphilis IgG/IgM$ - 0$ - 0
Toxoplasma IgG$ - 0$ - 0
Toxoplasma IgM$ - 0$ - 0
Varicella Zoster lgG$ - 0$ - 0
West Nile Virus IgG$ - 0$ - 0
Other (GPHL specified)$ - 0$ - 0
Total Estimate/by Fac$ - 0$ - 0
Total Annual Cost/Estimate Decatur/Waycross$ - 0
The Cost Proposal Worksheet is automatically populated by data entered into the corresponding cell(s) on the Cost Details worksheet (Tab1) of this workbook. The estimated number of units [Qnty/annual] per test indicated is based on FY2013 utilization data and is not intended as a guaranteed minimum or maximum order quantity.
NOTE: The price of each test/reagent must be all inclusive of the kit, supplies and consumables to perform validation of new assay and related costs, as well as instrument(s), ancillary equipment, supplies, parts and labor, shipping, preventative and on-demand maintenance, telephonic and onsite technical support, training, travel, lodging, expenses, etc.
I attest the information contained in this Cost Proposal and supporting Cost Details Worksheet is an accurate estimate of our organization's financial proposal for this bid event.
Authorized SignatureTitle

&C&"Arial Narrow,Bold"&12ATTACHMENT G Cost Proposal&"Arial Narrow,Regular"&10 &A &LGeorgia Department of Public Health&RPage &P of &N Printed on &D No Yes (Authorization for ETF must be attached or on file

Budget Summary

11BUDGET SUMMARY:
CategoryPer Unit AmtAnnual Amt
A. Personnel$
Fringe Benefits$
B. Regular Operating$
C. Travel$
D. Equipment$
E. Supplies$
F. Per diem/ Fees/Contracts$
G. Telecommunications$
H. Other$
Total Direct Costs$
I. Indirect Costs$
Total Project Costs$

Sheet1

Test/Reagent NameEst # Units/Tests DecaturEstimated Cost/Test DecaturEst # Units/Tests WaycrossEstimated Cost/Test Waycross
Cytomegalovirus IgG826$ 24.21- 0$ - 0
Cytomegalovirus IgM82$ 243.90- 0$ - 0
HSV Type Specific 16,253$ 3.20- 0$ - 0
HSV Type Specific 26,251$ 3.20- 0$ - 0
Measles IgG1,065$ 18.78- 0$ - 0
Measles IgM9$ 2,222.22- 0$ - 0
Mumps IgG1,031$ 19.40- 0$ - 0
Rubella IgG2,352$ 8.50- 0$ - 0
Rubella IgM10$ 2,000.00- 0$ - 0
Syphilis IgG/IgM4,099$ 4.88936$ 16.03
Toxoplasma IgG1,333$ 15.00- 0$ - 0
Toxoplasma IgM434$ 46.08- 0$ - 0
Varicella Zoster lgG1,431$ 13.98- 0$ - 0
West Nile Virus IgG- 0$ - 0- 0$ - 0
Other (GPHL specified)- 0$ - 0- 0$ - 0
Total Tests/Facility25,176$ 0.79936$ 16.03
Estimated Cost by Facility$ 20,000.00$ 15,000.00
$ 4,623.36

Other files

File Type Posted
Suppliers Q & A —
Minutes_Bidders Conference —
Addendum 02 —
Addendum 04 Closing Date Exten —
Prebid Conference Information —
Addendum 03 —
Pre-Bidders-Offerors (2) —

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